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Tuesday, May 7, 2013

Last week, I had the good fortune to attend the inaugural Human Resource Executive Health and Benefits Leadership Conference in Las Vegas. The real highlight for me was getting to sit down with a group of people I've been collaborating with online for years -- Fran Melmed, Carol Harnett and Bob Merberg. I have 13 pages of mind maps from the sessions I attended and I've been trying to decide what might be interesting to share. Here are a few of the highlights. You can get another perspective from Jen Benz's post. A number of participants Tweeted from the conference, so you can also view the Twitter Stream. And, be sure to check out the reading list I created from what was mentioned during the conference.Ron Leopold opened the conference with a presentation called "Are benefits forever?" He shared:7 Factors Driving Health Care Costs

We pay providers in ways that reward doing more, rather than being efficient.

We're growing older, sicker and more obese.

We want new drugs, technologies, services and procedures.

We get tax breaks on buying health insurance, and the cost to patients of seeking care is often low.

We don't have enough information regarding which medical care is best for us.

Our hospitals and other providers are increasingly gaining market share and are better able to demand higher prices.

We have supply and demand problems, and legal issues that complicate efforts to slow spending.

And, 10 Trends that will Impact Employee Benefits

Health care costs have been running 2-3x inflation for nearly two decades. People are living longer which is taxing the social security system and legions of baby boomers are entering an already bloated Medicare system.

Defined contribution worked in retirement because it contained employer financial liability. This will be equally attractive for health benefits. ACA rules will accelerate this imperative.

How we select benefits, submit a claim, check a balance, change coverage and interact with benefits services is becoming increasingly device-centric.

The war for talent is about skilled labor. Unskilled laborers have few opportunities.

Employers focus on productivity. To mitigate losses they focus on energy, resiliency, mental wellness and fulfillment.

Digital health is here to stay. The conversation continues in new and exciting ways: between patient and provider, consumer and vendor, and people with similar situations.

75 is the new 65. Seeing and hearing are becoming more important to people as they work longer. (Good news for ASHA members.)

The pendulum shifts on outsourcing with the cost/benefit shrinking to a point where we keep more jobs in the U.S.

Employers focus more on population health and matching the intervention to the level of risk.

What it means to "be employed" will look radically different. Think employer as exclusive club where access to value programs comes with membership.

During a Long Road to Wellness Bob Merberg and Jake Flaitz shared their experience at Paychex. They highlighted some of their wellness program keys to success:

The also shared three barriers they encountered when implementing their wellness program that I can definitely relate to:

Organizational culture

Technology (Things you expect to be simple like single sign-on can be real challenges.)

Employee wariness

The Ideas and Innovators session lead me to check out Good Rx to compare drug prices (your insurance isn't always the best deal) and Wiser Together to help health care consumers make evidence-based, cost-effective treatment decisions that are aligned to their personal preferences and financial constraints. I'm also thinking about holding a challenge that involves strengthening your memory and resilience, so I will definitely be checking out My Brain Solutions.

Finding better ways to measure absenteeism and presenteeism. The money spent on medical and pharmacy only account for 30% of the cost. Lost productivity accounts for another 70%. Absence data is also a good leading indicator of health issues in the workplace. AmEx uses the Work Limitations Questionnaire (WLQ) from Tufts Medical Center to measure productivity.

How are organization driving patients toward centers of excellence and premium designated providers and what measures are they using to gauge effectiveness? The lack of connection between cost and quality is befuddling. (The price of a hip/knee replacement can vary from $15,000 to $110,000.) How can we help consumers make informed decisions about their care?

If health = wealth in HSAs do people with chronic conditions feel estranged?

What process are organizations using to decide what behaviors to incentivize? How do you avoid incenting things that don't improve health -- e.g., incentives can lead to over screening of biometrics and many do not find health risk assessments useful.

Delaying the implementation of the exchanges by one year will save the government 80 billions dollars. It already seems highly unlikely that they'll be ready. Hearing this, it's hard to imagine that they won't be delayed.

Will employers feel less obligated to provide affordable coverage to spouses and dependents since they'll have other options for coverage? Will this create a confusing mess for families who each have their coverage through different providers? Who will help people? Will technology solutions be developed to aid families in this situation?

Will employers push active employees over age 65 and retirees toward exchanges? What will health care look like for retirees in the future?

There is a trend to bundling payments again. Bundle > Unbundle > Bundle. Everything old is new again.

Thinking about medical tourism. We know people will drive farther for dinner than to seek medical care. Will they really consider leaving the country as costs are shifted?

Fewer plan sponsors are carving out pharmacy benefits because it complicates CDHPs.

As you can probably tell, I was pretty focused on health care costs. Our claims experience is high right now, so I'm looking for things we can do to provide affordable, comprehensive coverage to our staff and their families in the future.

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